As I see it by Dr Brighton Chireka
I have been following the debate going on since the banning of multi-currency in Zimbabwe. Of particular interest is the proposal by our physicians to have their medical fees paid as RTGS to comply “with the law”.
Prior to this some of the physicians were being paid in USdollars and their fees ranged from US$80 to $120 for initial consultation. When the use of USdollars was “outlawed” it meant that they had to now charge in RTGS.
Private healthcare charges are subject to market forces like any other commodity.
The challenge comes as to what rate to use as the Zimbabwean economic market is VUCA( Volatile, Uncertain, Complex and Ambiguous). The rate can be 1 to 10 today and tomorrow could be 1 to 12 making it difficult to put a fixed fee for medical charges.
The problem of charging aside, let us examine the allegations that these fees will result in people dying at home. Majority of people are not able to afford and cannot be expected to afford medical fees being charged by private doctors. Private health care is there to complement public health care and not for it to be the main health system. It is the responsibility of the government to provide medical services to its citizens and not private doctors. It is the duty of the government to make sure that it is offering affordable quality health services to its people.
Access to healthcare is a basic human right and the government has a duty to ensure adequate provision is in place. The health of the people is the greatest law!
If the government does its job of providing affordable quality health services then private doctors can hike their fees as high as they want but it will not affect the majority of the population.
The problem in Zimbabwe is that we have a health system that is struggling and is not offering quality service. By quality I mean that the service has to be safe, timely , effective and must give a positive experience to the members of the public. We have hospitals that are operating without proper equipment and enough drugs. Abuja Declaration states we should be spending at least 15% of GDP on Health yet in Zimbabwe we are spending less than 10% of GDP. Zimbabwe is a signatory to the sustainable developmental goals (SDGs) which advocates for Universal health coverage. Universal Health Coverage exists when all people receive the quality health services they need without suffering financial hardship. Is this happening in Zimbabwe ? It seems the opposite is happening !
It must be made loud and clear that these private physicians are the same working in our government hospitals under difficulty conditions being paid peanuts. The reason why they are surviving is that during their spare time they are providing private medical services for a fee. If we ask them not to charge proper fees in the private whilst paying them peanuts in the public sector, we are trying to chase them away from the country. We should not complain when no one is left in our government hospitals .
Doctors do good for society, but it doesn’t mean you can’t do it for profit or ignore your needs and comfort. A doctor who treats people, but wants a decent life for himself is also really good for society. We must do away with this thinking that good people are necessarily poor or have no needs of their own.
It is my argument that private doctors’ fees should not affect the majority of us if our government is prioritising our health system . Private medical services should be optional and not be the first port of call. It should be for those who can afford and want special treatment. The rest of us should be able to get quality basic care in the government hospitals
If the specialist physicians reduce their fees to US$50 per visit, can we afford it ? I argue that with over 85% unemployment and only 10% on medical aid, the majority of us will not be able to afford private medical fees. Even if they offer their services for free in our public hospitals, it will not make any difference because our hospitals are empty with no equipment or drugs.
In view of this then the solution is not to bully the private doctors to work for peanuts. The solution is for the government to strengthen our public health system. Once our public health system has been strengthened then we can save lives . Failure to do that we will keep attacking doctors ignoring the elephant in the room. The fact is our public health facilities need proper investment and proper running period.
It is not about making popular statements that we are offering free health services in our hospitals. It is about making sure that those “ free hospitals” have equipment and drugs. It is about making sure that our health workers are happy to work and feel safe to look after us. What benefit is there if we have free hospitals that have no equipment or drugs ? Creating more demand without looking at the quality of services being offered kills many innocent lives.
Let us focus our energy on strengthening our public health system.